Shoulder dystocia.

What all MWs and OBs fear/respect.

Can happen in any birth without any warning, although we often have a hint that it might happen.

What happened today was incredible. I am exhausted and grateful.

Mom having 4th baby (all born at Baby Love) paged at 2 am with regular contractions. She was comfortable staying at home. Texted again at 7 am that contractions were 10 mins apart. At 8:15 she texted that the contractions took off and they were on their way. I rushed to get ready and meet them at the birth center.

I pulled up to see their car in front of the birth center and the dad looking frantic. When I got to the car, I found the mom in the passenger seat, spread eagled, with a dark purple baby head out.

I quickly asked mom to move to hands and knees and asked dad to call EMS. I did all of the usual maneuvers and the baby did not budge. Mom was pushing as hard as she could. I got scared and seriously thought that I might not be able to get the baby out.

I was doing the maneuvers in such a way as to prevent injuring the nerves to the arms, the most common injury that happens with shoulder dystocia is nerve injury that often resolves, but can lead to a paralyzed arm.

I had tried everything I knew how to do and baby was still stuck. I decided that a bad arm was less bad than a dead baby. So, I got mom back on her back and pulled really hard and baby came out.

Now I had a baby that wasn't breathing and I had no equipment or tools. I had no assistant. EMS was still on the way.

I did what needed to be done. I did mouth to mouth on the baby, while doing chest compressions. It would have been nice to know what baby's heart rate was, but without a stethoscope, I had no way to assess the heart rate. All of my equipment was inside the birth center and we were still in the parking lot in front of the birth center.

Baby started responding to my efforts at about a minute of life. EMS arrived at about 2 minutes of life and quickly got ambu bag going and continued chest compression.

Mom and baby were loaded into ambulances and headed to Health Park. Baby girl started breathing on her own in the ambulance.

Mom is completely fine and the ambulance crew got to deliver their first placenta. Baby girl is doing well. She did not need to be on a ventilator or CPAP. She is on a tiny bit of oxygen via nasal cannula. They are doing the cooling treatment that has been shown to prevent complications from birth injury.

Looking back, I can't believe it happened. I can't believe that all of the maneuvers that have worked so many times did not work. I can't believe that I got the baby out. I have never done mouth to mouth on a human before today.

I was alone, with no equipment and no assistant. It was all on me to save the baby.

And I did just that.

I am still in shock.

Update: baby girl was discharged from the hospital a few days later. She is perfectly healthy, probably due to the cooling treatment and is moving both arms normally. She weighed 9 pounds 3 ounces. Her parents named her Lucy, but to me, she will always be Lucky Lucy.